For the first time ever, in a special supplement, the journal "Cancer" has issued guidelines for low- and middle-income countries on the implementation of breast cancer programs. These programs are designed to detect and treat the disease which has become most common among women worldwide.

The "Guidelines for International Breast Health and Cancer Control - Implementation" developed by the Breast Health Global Initiative (BHGI) detailed a tiered system of resource allocation, based on countries' overall economic status and availability of resources, toward early detection, diagnosis, treatment, and developing an overall breast health program.

"The breast health guidelines for implementation will be an essential medical reference for low- and middle-income countries to improve breast health outcomes," said Benjamin O. Anderson, M.D., founder, chair and director of the Seattle-based BHGI organization BHGI.

"The BHGI guidelines are intended to assist ministers of health, policymakers, administrators and institutions in prioritizing resource allocation as breast cancer treatment programs are implemented and developed in their resource-constrained countries," the authors note in their overview of the 172-page supplement.

The supplement also contains other 16 articles by 56 authors from around the world, which are the culmination of work begun in 2002 when the first of three global summits on breast health took place.

"The development and implementation of these international evidence-based breast health care guidelines, which are oriented to countries or regions of the world with limited financial resources, is a crucial step toward improving breast health care and breast cancer care in these regions," said Anderson.

He added: "Current evidence about the value of earlier detection and cost-effective diagnosis and treatment can be applied to define best practices with limited resources for breast health care. While health care strategies may differ, measurable improvement in breast cancer outcomes can be achieved using the best standard of care that is practical in a given setting."

There is a marked geographical variation in case fatality rates associated with breast cancer, which are highest in developing countries and lowest in developed ones.

Also, women in poor- and middle-income nations generally are diagnosed when their cancer has progressed due to lack of resources to detect cancer earlier, resulting in increased morbidity and mortality.

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